Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea.
Department of Pathology, Chosun University College of Medicine, Gwangju, Korea.
Korean J Gastroenterol. 2021 Oct 25;78(4):235-239. doi: 10.4166/kjg.2021.097.
Preoperative imatinib treatment for rectal gastrointestinal stromal tumors (GISTs) has been reported to reduce the tumor size and help preserve the anal sphincter function. On the other hand, preoperative imatinib may prevent an accurate assessment of the recurrent risk. The endoscopic resection of rectal GIST is rarely reported because of challenges that include securing the visual field and avoiding perforation. This paper reports a case in which a 5.5×4.0 cm sized rectal GIST was treated effectively by an endoscopic submucosal dissection (ESD) without preoperative imatinib. To date, the patient had no tumor recurrence or complications and is receiving adjuvant imatinib treatment. This case shows that ESD may be a good treatment option to preserve the anus in rectal GIST treatment.
术前伊马替尼治疗直肠胃肠道间质瘤（GIST）已被报道可缩小肿瘤大小并有助于保留肛门括约肌功能。另一方面，术前伊马替尼可能会妨碍对复发风险的准确评估。由于包括确保视野和避免穿孔在内的挑战，直肠 GIST 的内镜下切除很少被报道。本文报告了一例 5.5×4.0cm 大小的直肠 GIST，在未行术前伊马替尼治疗的情况下通过内镜黏膜下剥离术（ESD）有效治疗。迄今为止，患者无肿瘤复发或并发症，并接受辅助伊马替尼治疗。该病例表明，ESD 可能是保留肛门的直肠 GIST 治疗的一种良好治疗选择。
